Gamma probe-directed lymphatic mapping and sentinel lymphadenectomy in primary melanoma: Reliability of the procedure and analysis of failures after long-term follow-up.

摘要: Background and Objectives Some patients presenting with cutaneous malignant melanoma without palpable adenopathy have regional metastatic disease. The results of a prospective clinical study γ probe-directed sentinel lymph node (SLN) biopsy are presented. Methods Over 3-year period, 103 diagnosis invasive primary (Breslow > 0.12 mm or > Clark level II) underwent preoperative lymphoscintigraphy technetium sulfur colloid followed by γ-probe-guided lymphadenectomy. There were 46 women 57 men mean age 55.7 years (range, 19–91). Results Mean Breslow thickness was 2.3 mm 0.12–10 mm). Primary locations head neck in 12, trunk 46, upper extremity 19, lower 26. One hundred sixteen basins mapped patients. Axillary, inguinal, cervical nodal comprised 55, 34, 11% the total evaluated, respectively. Sixty-eight (66%) lymphatic mapping one basin, 27 (26%) synchronous 2 basins, 6 (6%) 3 (2%) 4 basins. Seroma infection did not occur any Micrometastatic disease identified 15 sites 13 (10%) Of 10 undergoing dissection, 9(90%) had no additional pathological involvement. We achieved 99% success rate, 1% rate failed procedure, 8% false-negative after median follow-up for years. Conclusions We concluded that is straightforward procedure which can be done outpatient setting facilitates management melanoma. It allows surgeon to identify all at risk location node(s) relation basin. J. Surg. Oncol. 2001;77:157–164. © 2001 Wiley-Liss, Inc.